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Acute perioperative pain

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https://www.readbyqxmd.com/read/29779020/acetaminophen-reduces-acute-and-persistent-incisional-pain-after-hysterectomy
#1
Onur Koyuncu, Sedat Hakimoglu, Mustafa Ugur, Cagla Akkurt, Selim Turhanoglu, Daniel Sessler, Alparslan Turan
OBJECTIVE: Acetaminophen is effective for acute surgical pain, but whether it reduces persistent incision pain remains unknown. We tested the primary hypothesis that patients given perioperative acetaminophen have less incisional pain three months after surgery. Our secondary hypotheses were that patients randomized to acetaminophen have less postoperative pain and analgesic consumption, and better functional recovery at three months. METHODS: 140 patients having abdominal hysterectomy were randomly assigned to: 1)intravenous acetaminophen (4 g/day for 72 postoperative hours); or, 2) saline placebo...
May 15, 2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29772595/-case-report-metamizole-induced-agranulocytosis
#2
Falk A Gonnert, Winfried Meißner
Metamizole is primarily used for severe perioperative pain, acute injury and colic, and cancer pain. For other acute/chronic forms of pain and high fever, it should only be used if unresponsive to other agents. Metamizole should not be used for middle and low pain. Oral application should be preferred. A contraindication for metamizole is leukopenia. Clinical signs for agranulocytosis are fever, tonsillitis and aphthous stomatitis.
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29765320/distinct-analgesic-actions-of-dha-and-dha-derived-specialized-pro-resolving-mediators-on-post-operative-pain-after-bone-fracture-in-mice
#3
Linlin Zhang, Niccolò Terrando, Zhen-Zhong Xu, Sangsu Bang, Sven-Eric Jordt, William Maixner, Charles N Serhan, Ru-Rong Ji
Mechanisms of pain resolution are largely unclear. Increasing evidence suggests that specialized pro-resolving mediators (SPMs), derived from fish oil docosahexaenoic acid (DHA), promote the resolution of acute inflammation and potently inhibit inflammatory and neuropathic pain. In this study, we examined the analgesic impact of DHA and DHA-derived SPMs in a mouse model of post-operative pain induced by tibial bone fracture (fPOP). Intravenous perioperative treatment with DHA (500 μg), resolvin D1 (RvD1, 500 ng) and maresin 1 (MaR1, 500 ng), 10 min and 24 h after the surgery, delayed the development of fPOP (mechanical allodynia and cold allodynia)...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#4
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29759288/perioperative-surgical-home-for-the-patient-with-chronic-pain
#5
REVIEW
Talal W Khan, Smith Manion
The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29756086/postoperative-opioids-endocrine-changes-and-immunosuppression
#6
Simon Haroutounian
Opioids are among most effective drugs for managing acute postoperative pain. This article discusses the potential effects of perioperative opioids on endocrine and immune function.
March 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29756066/postanaesthetic-shivering-from-pathophysiology-to-prevention
#7
REVIEW
Maria Bermudez Lopez
Postoperative shivering is a common complication of anaesthesia. Shivering is believed to increase oxygen consumption, increase the risk of hypoxemia, induce lactic acidosis, and catecholamine release. Therefore, it might increase the postoperative complications especially in high-risk patients. Moreover, shivering is one of the leading causes of discomfort for postsurgical patients. Shivering is usually triggered by hypothermia. However, it occurs even in normothermic patients during the perioperative period...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29755709/perioperative-management-of-sickle-cell-disease
#8
REVIEW
Kwame Ofori Adjepong, Folashade Otegbeye, Yaw Amoateng Adjepong
Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29742787/-organisation-of-perioperative-pain-management
#9
Winfried Meißner, Joachim Erlenwein, Ulrike Stamer
Organisational issues of acute pain management are as important as details of pharmacologic treatments or regional analgesia. Lothar Lachgas is a young intern in the department of anaesthesiology of a German hospital. This overview illuminates organisation of perioperative pain management based on his virtual experiences and questions: pain assessment and documentation, patient information and education, tasks of an Acute Pain Service.
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29742783/-pro-epidural-analgesia-remains-the-gold-standard-for-abdominal-and-thoracic-surgery
#10
Hannah Listing, Daniel Pöpping
Pain relief with epidural analgesia is superior compared to systemic opioid analgesia after major abdominal and thoracic surgery. It remains a safe procedure, as long as it is embedded in a concept covering the whole perioperative period. This includes the knowledge of the anesthesiologist how to operate the process of catheter insertion as well as to treat complications like the hypotension, associated with the application of epidural local anesthetics. A close postoperative monitoring by an acute pain service team is a responsible task and should be available 24/7...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#11
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739537/opioid-free-anesthesia-opioid-side-effects-tolerance-and-hyperalgesia
#12
REVIEW
Patricia Lavand'homme, Arnaud Steyaert
Opioids are the most potent drugs used to control severe pain. However, neuroadaptation prevents opioids' ability to provide long-term analgesia and produces opposite effects, i.e., enhancement of existent pain and facilitation of chronic pain development. Neuroadaptation to opioids use results in the development of two interrelated phenomena: tolerance and "opioid-induced hyperalgesia" (OIH). Tolerance, a pharmacologic concept, and OIH, a clinical syndrome, have been mostly observed under experimental conditions in animals and in human volunteers...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#13
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29682602/acute-perioperative-comparison-of-patient-specific-instrumentation-versus-conventional-instrumentation-utilization-during-bilateral-total-knee-arthroplasty
#14
Jerrod A Steimle, Michael T Groover, Brad A Webb, Brian J Ceccarelli
Utilizing patient-specific instrumentation during total knee arthroplasty has gained popularity in recent years with theoretical advantages in blood loss, intraoperative time, length of stay, postoperative alignment, and functional outcome, amongst others. No study has compared acute perioperative measures between patient-specific instrumentation and conventional instrumentation in the bilateral total knee arthroplasty setting. We compared patient-specific instrumentation versus conventional instrumentation in the setting of bilateral total knee arthroplasty to determine any benefits in the immediate perioperative period including surgical time, blood loss, pain medication use, length of stay, and discharge disposition...
2018: Surgery Research and Practice
https://www.readbyqxmd.com/read/29676223/opiate-free-tricuspid-valve-replacement-case-report
#15
Jeffrey P Cardinale, George Gilly
The utility of opioid pain medications for perioperative analgesia is well described. However, opioids have many dangerous side effects including respiratory depression, acute tolerance, hyperalgesia, and chronic opioid dependence. Multimodal approaches continue to be used in more invasive and complex surgical procedures for enhanced recovery and decreased postoperative complications from opioid administration. The current case report centers on a 30-year-old male recovering from opioid addiction presenting with severe tricuspid regurgitation scheduled to undergo a tricuspid valve replacement...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29673040/focusing-on-optimising-laparoscopic-surgery
#16
Frank F Tu
van Dijk and colleagues add to the overall evidence for low intensity procedure modifications to improve surgical outcomes in this randomised controlled trial. Perioperative approaches to reduce acute pain are particularly relevant given new emphasis on reducing excess global opioid exposure. The presentation concisely summarises the physiological basis of commonly reported post-laparoscopy diaphragmatic pain. This article is protected by copyright. All rights reserved.
April 19, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29659470/meta-analysis-of-perioperative-outcomes-of-acute-laparoscopic-vs-open-repair-of-perforated-gastroduodenal-ulcers
#17
Roberto Cirocchi, Kjetil Soreide, Salomone Di Saverio, Elena Rossi, Alberto Arezzo, Mauro Zago, Iosief Abraha, Nereo Vettoretto, Massimo Chiarugi
BACKGROUND: Surgery is the treatment of choice for perforated peptic ulcer disease (PUD). The aim of the present review is to compare the perioperative outcomes of acute laparoscopic versus open repair for PUD. METHODS: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS and Web of Science RESULTS: The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29643713/modified-conjunctival-flap-as-a-primary-procedure-for-nontraumatic-acute-corneal-perforation
#18
Yi-Chen Sun, Jason P Kam, Tueng T Shen
Objective: Appropriate management of nontraumatic acute corneal perforation is always a challenge even with the many advances in surgical materials and techniques. We reported the outcomes of a case series of acute corneal perforation repair using a newly modified conjunctival flap with amniotic membrane transplant (AMT), fibrin glue, and a bandage soft contact lens (BCL). Materials and Methods: A total of 13 consecutive referral cases with nontraumatic acute corneal perforation at the University of Washington were reviewed...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#19
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29587906/-a-comparative-study-of-acute-and-chronic-pain-between-single-port-and-triple-port-video-assisted-thoracic-surgery-for-lung-cancer
#20
Caiwei Li, Meiqing Xu, Guangwen Xu, Ran Xiong, Hanran Wu, Mingran Xie
BACKGROUND: Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer. METHODS: Data of 232 patients who underwent single port -VATS (n=131) or triple port VATS (n=101) for non-small cell lung cancer (NSCLC) on January 1, 2016 to June 30, 2017 in our hospital were analyzed...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
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